Individual
MELISSA ANN IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCDC
Contact information
Practice address
4525 GLENWOOD AVE, DEER PARK, TX 77536-7901
(713) 909-9533
Mailing address
4525 GLENWOOD AVE, DEER PARK, TX 77536-7901
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15780
TX
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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